Optimising survival in malignant mesothelioma

The worldwide incidence of malignant pleural mesothelioma is still increasing. In the last few years an improvement in survival has been observed and much emphasis is given to early detection of this disease. However, early diagnosis by means of tumour markers and genomic analysis is still under investigation. In addition, all histological samples should be confirmed by an expert panel of pathologists to exclude other tumours. Currently, the preferred staging system is the one developed by the IMIG (International Mesothelioma Interest Group), but this requires surgical intervention. Standard treatment is the combination of cisplatin and pemetrexed based on phase III-study evidence, and therapy should be initiated as early as possible.